1. Technical Field
This disclosure concerns capturing charges for medical diagnosis and procedures, and presenting healthcare information, products and services to providers and patients. In particular, this disclosure relates to an efficient and economical approach to healthcare advertising and reporting utilization statistics to advertisers for content presented, selected or requested by a provider.
2. Background Information
Healthcare service providers (e.g., physicians, psychologists, nurse practitioners, physician assistants, therapists, and provider billing) employ a process known as charge capture that uses medical diagnosis and procedure codes (e.g., ICD-9 and CPT codes published by the American Medical Association AMA) to generate claims for reimbursements from payers (e.g., an insurance company, and Medicare) resulting from provider-patient encounters (e.g., patient consultation with a provider for treatment). Many healthcare service providers (providers) use handwritten charge cards or sheets to capture (charge capture) the medical diagnosis and procedures identified during the provider-patient encounter. Manual charge capture often leads to under coding, and over coding medical diagnosis and procedure codes resulting in payers rejecting claims. Manual charge capture also leads to improper and unidentified linking of procedure codes with diagnosis codes. Manual charge capture methods further lead to inefficiencies and inaccuracies that result in loss of revenue (e.g., failing to realize full reimbursements for services), as well as delayed reimbursements to providers.
Manual charge capture often includes the inefficient and cumbersome delivery of paper charge sheets to billing departments, the difficult task of deciphering the handwriting of providers, and inaccurate healthcare documentation jeopardizing the quality of healthcare delivered to patients. Outdated charge capture methods typically interface with outdated billing systems and methods that do not provide an efficient way to confirm that provider claims have met all the requirements of payers. The significant upfront financial outlay required to implement an automated charge capture system deters many providers from migrating away from manual charge capture, even though automated charge capture systems may enable a provider to realize a return on investment quickly.
The healthcare industry continues to realize the rapid development of medical products and services that providers may use in the treatment of patients. However, challenges exist for the healthcare industry to realize effective and economically efficient methods of delivering information to providers regarding medical products and services related to medical diagnosis and procedures identified during provider-patient encounters. Healthcare advertisers (e.g., medical suppliers, drug companies, medical equipment, and assisted living services) continually pursue opportunities to present information regarding their products and services to providers. However, advertisers require a method of advertising that enables advertisers to measure the effectiveness of their advertising investment.
Manual charge capture and the inability of providers to efficiently realize products and services relevant to medical diagnosis and procedures identified during provider-patient encounters prevent providers from delivering the most timely and greatest quality of healthcare to patients. Providers that use manual charge capture methods miss the opportunity to effortlessly review the latest available information regarding relevant products and services before prescribing treatment for patients. Providers and healthcare advertisers have a common need for a system and method that presents timely information regarding available products and services that facilitates delivery of the greatest quality of healthcare to patients.
A need has long existed for a system and method to effectively and economically implement electronic charge capture and deliver healthcare advertising to providers and patients.